prompt1 : extract information from  breast pathology report. List the histological classification, i.e. type of cancer or DCIS, subtype, description of any necrosis, any mention of tumor infiltrating lymphocytes,  histological grade, nuclear grade,  lymphovascular invasion, calcification, receptor status, IHC and any other ancillary testing results.  List out and expand the main points.
prompt2 : The report is - Subtype LumB, METHODOLOGY: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and no longer than 24 hours. Immunohistochemistry was performed using the mouse anti-human ER (ER 1D5, 1:100) and PR (PGR. 136, 1:100) provided by. following the manufacturer S instructions. This. assay was not modified. Interpretation of the ER/PR immunohistochemical stain is guided by published. results in the medical literature, information provided by the reagent manufacturer and by internal. review of staining performance. SYNOPTIC REPORT - BREAST HER-2 RESULTS. Specimen: Breast Core Needle Biopsy. Block Number: Interpretation: EQUIVOCAL. Intensity: 2+. % Tumor Staining: 10%. Fish Ordered: METHODOLOGY: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and no longer than 24 hours. Her2 analysis was performed using the FDA approved. HercepTest (TM) test kit. using rabbit anti-human HER2. This assay was not modified. External kit-slides. provided by the manufacturer (cell lines with high, low and negative HER2 protein expression) and in-. house known HER2 amplified control tissue were evaluated along with the test tissue. Adequate, well. preserved, clear-cut invasive carcinoma was identified for HER2 evaluation. Interpretation of the HER2. immunohistochemical stain is guided by published results in the medical literature, information provided. by the reagent manufacturer and by internal review of staining performance. This assay has been validated according to the. joint recommendations and guidelines from. ASCO and CAP and from the NCCN HER2 testing in Breast Cancer Task Force. The. Pathology Department takes full responsibility for this test's performance. FISH/ISH ANALYSIS REPORT 3. Specimens Involved. Specimens: B: RIGHT BREAST SUBAREOLAR CORE BIOPSY. HER2/NEU RESULTS. ANALYTICAL INTERPRETATION OF RESULTS. INDETERMINATE (EQUIVOCAL) FOR HER-2 AMPLIFICATION. Clinical interpretation of the results. A majority of tumors cells displayed 2 to CEP17 signals and 4 to 5 HER-2 signals, with a HER-2/CEP. 17 Ratio of 2. A HER-2/CEP 17 Ratio of >2.2 is generally considered amplification, while a ratio of 1.8. to <2.2 is generally considered indeterminate. This specimen is a biopsy and recommendation is to. repeat HER2 FISH test on resection specimen. Probes identification. .SI Her-2/neu 17q11.2-12, spectrumorange. CEP 17, 17 p11.1-q11.1 alpha satellite DNA, spectrumgreen. Image analysis method - Manual. Results interpreted. Number of invasive tumor cells counted. 100. Number of observers. 1. Number of Her2 signals/nucleus. 4.0. Number of CEP 17 signals/nucleus. 2.0. Her2/CEP 17 ratio. 2.0. TEST CHARACTERISTICS: PathVysion HER-2 DNA Probe Kit is FDA approved for selection of. patients for whom Herceptin therapy is being considered. These tests were performed in the Pathology. Core Facility, Department of Pathology,. under the direction of Dr.. The. results of these studies should always be interpreted in the context of the clinical, morphological, and. immunophenotypic diagnosis. The. PathVysion Kit is not intended for use to screen for or diagnose breast cancer. It is intended. to be used as an adjunct to other prognostic factors currently used to predict disease-free and overall. survival in stage II, node-positive breast cancer patients. In making decisions regarding adjuvant CAF. treatment, all other available clinical information should also be taken into consideration, such as tumor. size, number of involved lymph nodes, and steroid receptor status. No treatment decision for stage II,. node-positive breast cancer patients should be based on HER-2/neu gene amplification status alone. Specimen information. Block number used. Comment: Controls: The FISH study was performed with appropriately stained positive and negative controls. SPECIMEN(S): A. SLN #1 RIGHT AXILLA. B. LEFT BREAST TISSUE BIOPSY WITH NEEDLE LOCALIZATION. C. RIGHT BREAST TISSUE BIOPSY WITH NEEDLE LOCALIZATION. D. ADDITIONAL MEDIAL SUPERIOR MARGIN RIGHT BREAST. E. RIGHT AXILLARY CONTENTS. CLINICAL HISTORY: None Given. PRE-OPERATIVE DIAGNOSIS: Right breast cancer- left breast atypia. INTRAOPERATIVE CONSULTATION: TPA: SLN #1 right axilla- Positive for carcinoma. Diagnosis called to Dr. at by Dr. DIAGNOSIS: A. LYMPH NODE, SENTINEL #1, RIGHT AXILLA, EXCISION: - METASTATIC CARCINOMA TO ONE OF ONE LYMPH NODE (1/1),. MEASURING 0.3-CM WITH NO EXTRANODAL EXTENSION. B. BREAST, LEFT, WIDE LOCAL EXCISION: - FOCAL FIBROADENOMATOID CHANGES WITH COARSE. CALCIFICATIONS. - BIOPSY SITE CHANGES WITH FIBROSIS, GRANULATION TISSUE,. FOREIGN BODY GIANT CELL REACTION AND FAT NECROSIS, NO. TUMOR SEEN. C. BREAST, RIGHT, WIDE LOCAL EXCISION: - INVASIVE DUCTAL CARCINOMA WITH PAPILLARY AND FOCAL. MUCINOUS FEATURES, SBR GRADE 2, MEASURING 3-CM. - HIGH NUCLEAR GRADE, DUCTAL CARCINOMA IN SITU, SOLID,. MICROPAPILLARY, PAPILLARY AND CRIBRIFORM TYPES WITH. CENTRAL NECROSIS AND MICROCALCIFICATIONS. - SURGICAL RESECTION MARGINS NEGATIVE FOR TUMOR. - BIOPSY SITE CHANGES WITH FIBROSIS, GRANULATION TISSUE,. FOREIGN BODY GIANT CELL REACTION AND FAT NECROSIS. - SEE SYNOPTIC REPORT AND SEE NOTE. D. BREAST, RIGHT, ADDITIONAL MEDIAL SUPERIOR MARGIN, EXCISION: - BREAST TISSUE NO TUMOR SEEN. E. LYMPH NODES, RIGHT, AXILLARY DISSECTION: - FIFTEEN LYMPH NODES, NEGATIVE FOR METASTASES (0/15). NOTE: Invasive ductal carcinoma is identified in 5 consecutive slices from lateral to. medial, measuring about 3.0 CM. HER-2/neu test by FISH is ordered, since the core needle biopsy results were equivocal. SUMMARY OF IMMUNOHISTOCHEMISTRYISPECIAL STAINS. Material: Block A1. Population: Lymph Node. Stain/Marker: Comment: CYTOKERATIN AE1/3. Positive. CYTOKERATIN 7. Negative. S-100. Negative. ESTROGEN RECEPTOR. Positive. Material: Block C7. Population: Tumor Cells. Stain/Marker: Comment: CYTOKERATIN AE1/3. Positive. CYTOKERATIN 7. Negative. S-100. Negative. ESTROGEN RECEPTOR. Positive. Material: Block C12. Population: Tumor Cells. Stain/Marker: Comment: P63. Negative. CALP. Negative. SMOOTH MUSCLE. Negative. MYOSIN. The interpretation of the above immunohistochemistry stain or stains is guided by published results in the medical literature, provided. package information from the manufacturer and by internal review of staining performance and assay validation within the. Immunohistochemistry Laboratory of the. The use of one or more reagents in the above tests is. regulated as an analyte specific reagent (ASR). These tests were developed and their performance characteristic determined by the. Department of Pathology Laboratory at. `hey have not been cleared or approved by the U.S. Food and. Drug Administration. The FDA has determined that such clearance or approval is not necessary. Special stains and/or immunohistochemical stains were performed with appropriately stained positive and/or negative. controls. SYNOPTIC REPORT - BREAST. Specimens Involved. Specimens: A: SLN #1 RIGHT AXILLA. C: RIGHT BREAST TISSUE BIOPSY WITH NEEDLE LOCALIZATION. D: ADDITIONAL MEDIAL SUPERIOR MARGIN RIGHT BREAST. E: RIGHT AXILLARY CONTENTS. Specimen Type: Excision. Needle Localization: Laterality: Right. Invasive Tumor: Present. Multifocality: No. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 3cm. Margins: Negative. Distance from closest margin: 0.4cm. anterior. Tubular Score: 2. Nuclear Grade: 3. Mitotic Score: 3. Modified Scarff Bloom Richardson Grade: 2. Necrosis: Absent. Vascular/Lymphatic Invasion: None identified. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node. Axillary dissection. Lymph node status: Positive 1 / 16. Micrometastases: DCIS present. Margins uninvolved by DCIS. DCIS Quantity: Estimate 10%. DCIS Type: Cribriform. Micropapillary. Papillary. DCIS Location: Associated with invasive tumor. Nuclear grade: High. Necrosis: Present. Location of CA++: DCIS. ER/PR/HER2 Results. ER: Positive. PR: Positive. HER2: Pending by FISH. Performed on Case: ER/PR. on case. HER2 by FISH pending on the current case. Pathological staging (pTN): pT 2 N la. Pathological staging is based on the AJCC Cancer Staging Manual, 7th Edition. GROSS DESCRIPTION: A. SLN #1 RIGHT AXILLA. Received fresh labeled with the patient's identification and 'SLN #1 right axilla' is a tan. pink lymph node 1.7 X 0.9 X 0.7cm. The specimen is serially sectioned. A touch prep is. taken. Toto A1. B. LEFT BREAST TISSUE BIOPSY WITH NEEDLE LOCALIZATION. Received in formalin labeled with the patient's identification and 'left breast tissue. biopsy with needle localization' are two oriented, previously inked lumpectomy. specimens 59g and 53g each - when placed back together by the surgeon, measuring 11.5. x 8 x 4.5cm. Ink code- anterior-yellow, posterior-black, superior-blue, inferior-orange,. medial-green, lateral-red. Specimen is serially sectioned in to 15 slices revealing a 0.6 x. 0.5 x 0.5cm previous biopsy site with surrounding necrosis, at the anterior margin in. slices 4-5-6. The specimen is radiographed and areas of concern are marked by the. radiologist. A biopsy clip is identified in slice 5. Representatively submitted: B1-B2: medial margin slice 1. B3: anterior margin slice 2. B4: anterior margin slice 3. B5: bx site with anterior margin slice 4. B6: inferior margin slice 4. B7: bx site with anterior margin and clip ID slice 5. B8: superior margin slice 5. B9: posterior margin slice 5. B10: inferior margin slice 5. B11: bx site with anterior margin slice 6. B12: superior-posterior margin marked by the radiologist slice 14. B13-B14: inferior margin slice 14. B15: lateral margin marked by the radiologist slice 15. C. RIGHT BREAST TISSUE BIOPSY WITH NEEDLE LOCALIZATION. Received in formalin labeled with the patient's identification and 'right breast tissue. biopsy with needle localization' is an oriented, previously inked 201g, 15.2 x 11 x 3.4cm. needle localized lumpectomy with two radiographs. Ink code- anterior-yellow, posterior-. black, superior-blue, inferior-orange, medial-green, lateral-red. Specimen is serially. sectioned in to 11 slices revealing a tan white gelatinous lobulated mass 5.3 x 4 x 2.8cm,. 0. 1cm from the closest anterior and posterior margins in slices 2-3-4-5-6-7 and 8. A. portion of the specimen is submitted for tissue procurement. Representatively submitted: C1: lateral margin slice 1. C2: mass with anterior margin slice 2. C3: mass with anterior margin slice 3. C4-C5: mass with anterior margin slice 4. C6-C8: mass with anterior margin slice 5. C9: superior margin slice 5. C10-C11: mass with posterior margin slice 6. C12: mass with posterior margin slice 7. C13: anterior - inferior margins slice 7. C14: mass slice 8. C15: inferior margin slice 9. C16: posterior margin slice 10. C17: medial margin slice 11. D. ADDITIONAL MEDIAL SUPERIOR MARGIN RIGHT BREAST. Received in formalin labeled with the patient's identification and "additional medial. superior margin right breast' is an oriented 37g, 7 x 7 x 3cm fibrofatty tissue. Final. margin inked blue. Serial sectioning reveals unremarkable parenchyma. Representatively. submitted in D1-D6. E. RIGHT AXILLARY CONTENTS. Received in formalin labeled with the patient's identification and "right axillary contents'. are multiple tan pink fragments of fibrofatty tissue aggregating to 15 x 8 x 3.5cm. Dissection reveals sixteen lymph nodes ranging from 3.5 x 2.4 x 1.6cm to 0.2 x 0.2 x. 0.2cm. E1: five lymph nodes. E2: five lymph nodes. E3: two lymph nodes. E4: one lymph node. E5-E6: one lymph node. E7-E8: one lymph node. E9-E10: one lymph node. ADDENDUM: FISH/ISH ANALYSIS REPORT 3. Specimens Involved. Specimens: C: RIGHT BREAST TISSUE BIOPSY WITH NEEDLE LOCALIZATION. HER2/NEU RESULTS. ANALYTICAL INTERPRETATION OF RESULTS. HER-2 NOT AMPLIFIED. Clinical interpretation of the results. A majority of tumors cells displayed moderate polysomy 17 with 2 to 3 chromosome 17. centromere signals and 2 to 4 HER2 signals, with a HER2/CEP 17 Ratio 1.5, consistent with. no amplification of the HER2/neu gene. Probes identification. LSI Her-2/neu 17q11.2-12, spectrumorange. CEP 17, 17 p11.1-q11.1 alpha satellite DNA, spectrumgreen. Image analysis method - Manual. Results interpreted. ISCN. nuc ish: (CEP17x2),(HER2x3)[200]. Number of invasive tumor cells counted. 200. Number of observers. 1. Number of Her2 signals/nucleus. 3.2. Number of CEP 17 signals/nucleus. 2.2. Her2/CEP 17 ratio. 1.5. TEST CHARACTERISTICS: HER-2 DNA Probe Kit is FDA approved for. selection of patients for whom Herceptin therapy is being considered. These tests were. performed in the Pathology Core Facility, Department of Pathology,. under the direction of Dr.. The results of these studies should always be. interpreted in the context of the clinical, morphological, and immunophenotypic diagnosis. The. Kit is not intended for use to screen for or diagnose breast cancer. It. is intended to be used as an adjunct to other prognostic factors currently used to predict. disease-free and overall survival in stage II, node-positive breast cancer patients. In. making decisions regarding adjuvant CAF treatment, all other available clinical. information should also be taken into consideration, such as tumor size, number of. involved lymph nodes, and steroid receptor status. No treatment decision for stage II,. node-positive breast cancer patients should be based on HER-2/neu gene amplification. status alone. Specimen information. RPCI surgical pathology/cytology case number. Source of case. RPCI. Block number used C7. Specimen site. Breast. Female breast right. Specimen type. Complete excision (less total mastectomy). Specimen fixative type. Formalin. Duration of fixation (hrs). 6 48 hrs. Comment: Controls: The FISH study was performed with appropriately stained positive and negative. controls. ADDENDUM: ONCOTYPE DX BREAST CANCER ASSAY. RESULTS: Recurrence Score: 27. CLINICAL EXPERIENCE: Patients with a recurrence score of: 27 in the clinical validation. study had an average rate of Distant Recurrence at 10 years of 18%. ER Score: 12 Positive. PR Score: 6.7 Positive. Her2 Score: 9.1 Negative. Interpretation: ER. Negative < 6.5 Positive >= 6.5. PR. Negative < 5.5 Positive >= 5.5. Her2 Negative <10.7 Positive >= 11.5 Equivocal = 10.7 - 11.4. See separate. report for further information. left breast bx. SPECIMENS: A. LEFT BREAST CENTRAL CORE BIOPSY. B. RIGHT BREAST SUBAREOLAR CORE BIOPSY. SPECIMEN(S): A. LEFT BREAST CENTRAL CORE BIOPSY. B. RIGHT BREAST SUBAREOLAR CORE BIOPSY. DIAGNOSIS: A. BREAST, LEFT, CENTRAL, BIOPSY: - MINUTE FRAGMENTS OF ATYPICAL CELLS WITH NECROSIS. - STROMAL CALCIFICATIONS, SEE NOTE. NOTE: Scattered minute fragments of crushed cells with necrosis are identified. They may represent. contents of DCIS. Multiple levels are examined. Excisional biopsy is recommended. B. BREAST, RIGHT, SUBAREOLAR, BIOPSY: - INVASIVE DUCTAL CARCINOMA, SBR GRADE 2, SEE NOTE. NOTE: Maximum invasive tumor size measures 0.8-cm. This measurement may not reflect the actual. size of the tumor. Breast biomarkers are ordered. GROSS DESCRIPTION: A. LEFT BREAST CENTRAL CORE BIOPSY. Received in formalin labeled with the patient's identification and 'left breast central core biopsy' are. multiple tan vellow cores of tissue ranging from 4.3 x 0.2cm to 0.5 x 0.2cm. Toto A1-A2. Time placed in. formalin-. B. RIGHT BREAST SUBAREOLAR CORE BIOPSY. Received in formalin labeled with the patient's identification and 'right breast subareolar core biopsy' are. four tan yellow cores of tissue ranging from 1.1 x 0.1cm to 0.5 x 0.1cm. Toto B1. Time placed in. formalin-. CLINICAL HISTORY: A) Suspicious calcification in central left breast. B) New mass - highly suspicious for cancer. PRE-OPERATIVE DIAGNOSIS: A) Rule out DCIS. ADDENDUM: SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimen: Breast Core Needle Biopsy. Block Number: ER: Positive. Allred Score: 8 = Proportion Score 5 + Intensity Score 3. PR: Positive Allred Score: 5 = Proportion Score 2 + Intensity Score 3. COMMENT: The Allred score for estrogen and progesterone receptors is calculated by adding the sum of the. proportion score (0 = no staining, 1 = <1% of cells staining, 2 = 1 - 10% of cells staining, 3 = 11-30% of. cells staining, 4 = 31-60% of cells staining, 5 = >60% of cells staining) to the intensity score (1 = weak. intensity of staining, 2 = intermediate intensity of staining, 3 = strong intensity of staining), with a scoring. range from 0 to 8. ER/PR positive is defined as an Allred score of >2 and ER/PR negative is defined as an Allred score. of less than or equal to 2.

expanded version (tokens=4901) : 
 Histological classification:
- Left breast central core biopsy: Suspicious calcification, rule out DCIS
- Right breast subareolar core biopsy: Invasive ductal carcinoma, SBR Grade 2

Subtype:
- LumB

Description of any necrosis:
- Left breast central core biopsy: Minute fragments of atypical cells with necrosis
- Right breast subareolar core biopsy: No mention of necrosis

Tumor infiltrating lymphocytes:
- No mention of tumor infiltrating lymphocytes

Histological grade:
- Right breast subareolar core biopsy: SBR Grade 2

Nuclear grade:
- Right breast subareolar core biopsy: High nuclear grade

Lymphovascular invasion:
- No mention of lymphovascular invasion

Calcification:
- Left breast central core biopsy: Stromal calcifications

Receptor status:
- ER (Estrogen receptor): Positive
- PR (Progesterone receptor): Positive

IHC and other ancillary testing results:
- HER2 (Human epidermal growth factor receptor 2): Equivocal result on immunohistochemistry (2+ with 10% tumor staining)
   - FISH ordered for further testing
   - FISH results: HER-2 not amplified
- Oncotype DX Breast Cancer Assay: Recurrence Score of 27
   - ER Score: Positive
   - PR Score: Positive
   - Her2 Score: Negative

Note: Excisional biopsy

prompt : Please generate a succinct report in 75 words from the above information. Exclude any filler words or sentences. If something is not mentioned or specified, exclude it from the report. Low verbosity.

final output (tokens=5091) : 
 Histological classification: Left breast central core biopsy - suspicious calcification, Right breast subareolar core biopsy - invasive ductal carcinoma, SBR Grade 2. Subtype: LumB. Necrosis: Present in left breast biopsy. Tumor infiltrating lymphocytes: Not mentioned. Histological grade: SBR Grade 2 in right breast biopsy. Nuclear grade: High in right breast biopsy. Lymphovascular invasion: Not mentioned. Calcification: Stromal calcifications in left breast biopsy. Receptor status: ER and PR positive. HER2 status: Equivocal on IHC (2+ with 10% tumor staining), FISH pending. Oncotype DX Recurrence Score: 27

